Baucom's Nursery Phase 3 - 180414.300 NCDEQ Stormwater Fast Track Permit Application

Date Received Fie Paid Permit Number
SW Program(s): ❑ Coastal SA -HOW ❑ Coasts' SA-ORW ❑ Coastal FW-ORW ❑ Coastal Other
❑ Non -coastal HQW ❑ Non-c; astal ORW ❑ Urbanizing Areas ❑ USMP
NC Q DivisionEnergy,• Land Resources
STATE STORVWATERPROCESS:
"AUTHORIZATION TO CONSTRUCT" (ATC) PERMIT APPLICATION FORM
Link to Application Instructions
A. ELIGIBILITY FOR FAST -TRACK PERMITTING
To be considered for a Fast Track ATC Permit, all of the items below must be checked. If any item cannot
be checked, then the project must apply under the Standard Permitting Process.
® The project and all SCMs (including existing SCMs associated with the project) will meet all applicable
requirements of 15A NCAC O2H .1000 - .1062, including the Minimum Design Criteria (MDC), upon project
completion.
® The project is not proposing an alternative design.
® The project is not claiming an exemption from the MDC based on vested rights, a waiver or a Director's
Certification.
® The project is not out of compliance with an existing stormwater permit or any other environmental permit.
® The project is not applying for an offsite permit, an exemption, or a minor modification (as defined in 15A
NCAC O2H .1002(25)) to an existing stag stormwater permit.
® The project application bears the signature and seal of a professional licensed pursuant to either Chapter 89A
or 89C of the NC General Statutes. I-*
® I understand that at project completion, an application with the as -built stormwater plans (as described in 15A
NCAC 02H .1044 must be submitted, ands DEQ will review the as -built stormwater plans to confirm compliance
with the MDC. Approval of the as -built sfb'rmwater plans will be required before the Erosion and
Sedimentation Control Plan for the project may be closed out.
�:
® I understand that the Fast Track ATC Permit will expire five years after the date of issuance.
1 Project Name: Baucom's Nursery Phase 3a and 3b
2. Previous Project Name (if applicable): N/A
3. Location of Project (street address): 2600 Flowes Store Rd. E.
City:Concord County:Cabarrus Zip:28O25
4. Directions to project (from nearest major intersection):
From the intersection of Hwy 24/27 and Hwy 601, head north on Hwy 601. Turn left onto Flowes Store Road
East, and the proiect site will be on the left. This proiect is Phase 3 of the existing Baucom Nursery site, and
is accessed from the existing two phases.
5. Latitude:35° 17' 44.06" N Longitude:800 31' 49.10" W of the main entrance to the project.
C. PERMIT INFORMATION
1. Specify whether project is (check one):
® New, no previous application
❑ New, replacing a previous Fast Track ATC Permit -- provide previous permit number: SWA
Stormwater Fast Track ATC Application Form Page 1 of 11 Feb. 10. 2018

By choosing this option, you are also requesting that DEQ rescind the previous Fast Track A TC Permit
upon issuance of the new Fast Track A TC Permit.
Stormwater Fast Track ATC Application Form Page 2 of 11 Feb. 10,2018

❑ Major Modification, replacing an existing stormwater permit — provide existing permit number: SW
Status of construction? ❑ Not Started ❑ Partially Completed ❑ Completed
Major modifications must be submitted by the original permittee and are allowed only if the SW permit is
not expired. Minor modifications must use Standard Permitting Process. By choosing this option, you
are also requesting that DEQ rescind the previous SW Permit upon issuance of the new Fast
Track ATC Permit.
❑ Transfer of existing Fast Track ATC Permit — provide existing ATC permit number: SWA
2. Applicable state stormwater program(s) (check all that apply):
❑ Coastal SA-HQW Z Urbanizing Areas (Phase 2)
❑ Coastal SA-ORW ❑ Non -Coastal HQW
Is any portion of the project within 575 feet
of SA-ORW waters? ❑ Yes ❑ No ❑ Non -Coastal ORW
❑ Coastal Freshwater ORW ❑ USMP
❑ Coastal — Other
3. Other Permits (as applicable; write "NA" for those permit types that are not applicable):
Project Name
Permlt/Appl
Issue Date
Other Information
No.
CAMA Major
N/A
-
Erosion &
Baucom's Nursery Phase 3
CABAR-
2/25/2019
Disturbed Area
Sedimentation Control
2019-057
40.764 acre
NPDES Industrial
N/A
Stormwater
404/401 Permit
I I
N/A
Proposed Impacts
I If/ac
4. Local jurisdiction for building permits: Cabarrus County
Point of Contact:Wayne Krimminger Phone#: [phone]
1. Applicant/Financially Responsible Party (may be an Organization): Baucom's Nursery Company
Signing Official Name & Title:Ga!y Baucom, President/CEO
Street Address:28256
City:Charlotte State:NC Zip:28213
Mailing Address (if different):PO Box 560008
City:Charlotte State:NC Zip:28256
Phone: [phone] Fax:
Email: qcb(cb-baucomnursery.com
2. If the Applicant is a Corporation or LLC (Address must match address on file with NC Dept of the Secretary of
State):
Name of Registered Agent:Ga[y C. Baucom
Mailing Address:PO Box 560008
City:Charlotte State:NC Zip:28213-0008
Phone: [phone] Fax:
Email:acb(a-)baucomnursery.com
Stormwater Fast Track ATC Application Form Page 3 of 11 Feb. 10,2018

3. The Applicant is the (check all that apply):
Property Owner
❑ Lessee (Attach a copy of the lease agreement & complete Item 4.)
❑ Purchaser (Attach a copy of the pending sales agreement & complete Item 4.)
El Developer (Attach a copy of the development agreement & complete Item 4.)
4. If the Applicant is NOT the Property Owner (skip to Item 5 if the Applicant IS the Property Owner):
Property Owner Name/Organization:
Signing Official & Title:
Street Address:
City: State: Zip:
Mailing Address (if applicable):
City: State: Zip:
Phone: Fax:
Email:
5. The licensed Design Professional that will be retained for the duration of the project, who may provide
information on the Applicant's behalf, and who will prepare and certify the as -built package:
Consulting Engineer/Landscape Arch itect:Catherine W. Underwood, PE
Consulting Firm: CESI, Inc.
Mailing Address:PO Box 268
City:Concord State:NC Zip:28026-0268
Phone: (980 ) 234-7500 Fax: [phone]
Email:kateunderwoodO-cesicqs.com
6. [OPTIONAL] If you would like to designate another person to answer questions about the project:
Name & Title:
Organization: _
Mailing Address:
City:
Phone:
Email:
Pflffa����* 1X;
State: Zip:
Fax: (
1. Specify the type of project (check one): E] Low Density Z High Density
2. Briefly summarize how the stormwater runoff will be treated/conveyed:
Stormwater Fast Track ATC Application Form Page 4 of 11 Feb. 10,2018

The runoff from the project site is collected in a series of swales which are then collected in a stormwater
conveyance system which outfalls to a large forebay and subsequent wet detention stormwater control
measure (SCM). This SCM provides water quality and attenuation in accordance with the minimum design
criteria as outlined by DEQ for wet pond SCIVIs.
3. Stormwater runoff from this project drains to the Yadkin Pee -Dee River basin(s).
4. Receiving water information (if more than 3 receivinq waters, provide additional information on an attached sheet):
gua
.......... d6iv
"M M,
'6
",\"\",\ . . ............. ..
=qg .
P I
Receiving Stream Name
Anderson Creek
Stream Classification
C
Stream Index Number
13-17-13
Stormwater Fast Track ATC Application Form Page 5 of 11 Feb. 10,2018

5.
f✓ro ect area ano ciensity intormation:
Total Property Area 3,831,276
sf
Total Coastal Wetlands Area ( 0 sf
Considered to include: coastal wetlands landward from the NHW (or MHW) line.
Built -Upon Area (BUA) associated with Existing Development 0 sf
"Existing development" means those projects that are built or those projects that have established a
vested right under North Carolina law as of the effective date of the state stormwater program or
applicable local government ordinance to which the project is subject.
Project Density
wl Existing Development: Project Density = [New BUA]I(Total Project Area —Existing BUA) x 100 or 72.3 %
wlo Existing Development: Project Density = [New BUA]ITotal Project Area] x 100
6. Anticipated construction start date 6.1.19
7. Is the project located within 5 miles of a public airport? ® No ❑ Yes
If'Yes,'see S.L. 2012-200, Part VI: http://www.neleg.net/Sessions/2011/Bills/Senate/PDF/S229v6.pdf and
DEQ Stormwater Design Manual Chapter E-4 Airports.
8. For projects in Union County: Contact DEMLR Central Office Stormwater staff at 919-707-9200 to determine if
the project is located within a Threatened & Endangered Species watershed that may be subject to more
stringent stormwater requirements per 15A NCAC 02B .0600.
Stormwater Fast Track ATC Application Form Page 6 of 11 Feb. 10, 2018

Submit the application package to the appropriate DEMLR Regional Office (Coastal, SA Waters) or DEMLR
Central Office (Urbanizing Areas Ph 2, USMP, Non -Coastal HQW/ORW). Only application packages that include
all required items listed below will be accepted and reviewed.
Initial each item below to indicate that the required information is provided in the application package:
Initials
KWU 1. Two original signed hard copies and one electronic copy of this State Stormwater Fast Track
Process "Authorization to Construct" (ATC) Permit Application Form.
KWU 2. Permit application processing fee of $505 payable to NCDEQ.
KWU 3. Two hard copies and one electronic copy of a USGS map identifying the project location
and GPS coordinates for the project. If the receiving water is Class SA or the receiving water
drains to Class SA waters within % mile of the project boundary, include the %Z mile radius
on the map. If the project is within 575 feet of Class SA-ORW waters, include the 575-foot
radius on the map.
KWU 4. Two original signed hard copies and one electronic copy of a site plan depicting the boundary
of the project or project phase currently being permitted, including the locations of SCMs,
streams, wetlands, and buffers.
KWU 5. Two hard copies and one electronic copy of a construction sequence that discusses how any
future development on the project may be phased.
KWU 6. A copy of the most current property deed. Deed book: 12780 Page No: 0091
KWU 7. [IF APPLICABLE] When the applicant is a corporation or a limited liability corporation (LLC): Provide
two hard copies and one electronic copy of documentation from the NC Secretary of State, or other
official documentation, which supports the titles and positions held by the persons listed
in Section C.2 per 15A NCAC 2H. 1043(3)(b). The corporation or LLC must be listed as an active
corporation in good standing with the NC Department of the Secretary of State; otherwise, the
application will be returned. https://www.sosne.gov/search/index/corp
N/A 8. [IF APPLICABLE] When the applicant is a Partnership or other person engaging in business under
an assumed name, attach a copy of the Certificate of Assumed Name.
NIA 9. [IF APPLICABLE] When the applicant is not the property owner: Provide two hard copies and one
electronic copy of lease agreements, affidavits, pending sales agreement, development agreement,
or other documents showing that the applicant has obtained legal rights to submit a stormwater
permit application within the proposed project area.
N/A 10. [IF APPLICABLE] If modifying an existing permit for completed or partially completed projects, a copy
of the designer's certification.
Stormwater Fast Track ATC Application Farm Page 7 of 11 Feb. 10, 2018

G. CERTIFICATION OF APPLICANT/ FINANCIALLY RESPONSIBLE PARTY
The Applicant, who is also the Financially Responsible Party, identified in Section D of this form must sign and have
notarized the following guaranty:
|. (print ortype name of ApplicantlFinancially Responsible Patty)
certify that the information included on this permit application form is, to the best of my knowledg6, correcrand
that:
1. the design has been or will be completed in accordance with the MDC as set forth in Rules 15A NCAC
02H .1050 through .1062, to the best of my knowledge;
2. the completed de`gnmeets orwill meet the yNOC and that the percentage BUAthat iothe basis for the
design shall not boexceeded, tothe best cfmnyknowledge; and
3. As the applicant, I shall maintain a licensed professional of record for the duration of the project
who will prepare and certify the as -built package. |f|retain another licensed
professional before the project is complete, then I shall provide an updated
guaranty with the current licensed professional's seal. Alicensed professional shall inform
the Division ifhmionnlonger associated with this project.
The above information is true and correct to the best of my knowledge and belief and was provided by me under oath |
agree bnprovide corrected information should there beany change in the information provide herein.
Type orprint name Title urAuthority
[ aNotary Public for the State Vf County
of (166ecrof> , do hereby certify that personally
appeared before methis C2
day of and acknowledge the due execution of
the application for a stormwater permit. Witness my hand and official seal,
My commission expires
ESUSAN ARIE SCHWARTZ
PUBLIC
M L or CarolinTaZ
NOTARY PUBUC
Cabarrus county, North Carolina
my commission =F_xores
Stormwater Fast Track /gACApplication Form Page Gof1i Feb.10.2018

Tobecompleted bvthe Design Professional identified inSection O.5.
1, Catherine Wolf Underwood , attest to the following:
1.This application has been reviewed by me and is accurate and complete, to the best of my knowledge;
2. The design has been completed inaccordance with the MDCmnset forth inRules 15&NCACU2H
.185Othrough .1OO2.aeapplicable;
3. The percentage built -upon area that is the basis for the design will not be exceeded; and
4. | have the expertise, education, and experience requiredtodesign the 8CMoproposed inthis
application in accordance with the MDC as set forth in Rules 15A NCAC 02H .1050 through .1062.
S. 1 will provide all documents and certified as -built plans in hard copy and electronic format related to this
permit to a new Applicant/Property Owner and to DEMLR upon transfer of this permit to a new
App||cant/PropehyOwner.
Note: |naccordance with N.(|.G.S.143-215.0Aand 143-215.8B.any person who knowingly makes any false
statement, representation, orcertification inany application shall beguilty uofoClass 2misdemeanor which may
include a fine not to exceed $10,000 as well as civil penalties up to $25,000 per violation. |naddition, any person
who knowingly makes any false statement, representation, or certification in any application may be reported to
the appropriate C fessi I licensing board.
Signature: Date: D5/O2/2019
fill
05102/2019
StoxnnvaterFast Track AJCApplication Form Page Qof11 Fmb 1O,2018

|. (print ortype name ufthe Property certify that |
own the property identified inthis permit application, and thus give permission to(print ortype name nf
with (print ortype name ofApplicant's
organization) to develop the project as
currently proposed. A copy of the lease agreement or pending property sales contract has been provided with the
submittal, which indicates the party responsible for the operation and maintenance of the stormwater system.
As the |m0a| propertyovvner|enknovvedge.underetand.andagneebymyaignmtunybe|oxv.thatifnnydenignoted
agent (entity listed inContact Information, item 1 dissolves their company and/or cancels ordefaults ontheir
lease agreement, or pending sale, responsibility for compliance with the DEMLR Stormwater permit reverts back
to me, the property owner. As the property owner, it is my responsibility to notify DEMLR immediately and submit a
completed Name/Ownership Change Form within 30 days; otherwise I will be operating a stormwater treatment
facility without avalid permit. I understand that the operation of a stormwater treatment facility without a valid
permit ieaviolation of NC General Statue 143-215.1 and may result inappropriate enforcement action including
the assessment ofcivil penalties ofupto$25.0UOper day, pursuant tVNCG8143-215.0.
Signature:
a Notary Public for the State of
of , do hereby certify that
___
, County
personally
appeared before methis day uf _______.mnd acknowledge the due execution of
the application for aotormvvotmrpermit. Witness myhand and official seal,
My commission expires
Stormwater Fast Track ATC Application Form Page 10 of 11 Feb.10,2018

J. CERTIFICATION OF CURRENT PERMITTEE (COMPLETE ONLYIF PERMIT TRANSFER IS
|' am submitting
this request for otransfer ofFast Track /TCpermit # SWA With the
submission ofthis transfer request|omnproviding ocopy ofthe most recentpennU all related documents and
built plans certified by my design professional in hard copy and electronic format to the Proposed
Perm ittee/Appl icant identified in Section G of this application and to D EM LR . I further attest that this request for a
permit transfer is accurate and complete to the best of my knowledge. I assign all rights and obligations as
permittee to the proposed permittee named in Section G of this form.
SigData:
1, , a Notary Public for the State of
of dohereby certify that
appeared before mnethis day of______
County
personally
___, and acknowledge the due execution of
the application for aotorn/waterpermit. Witness rnyhand and official seal,
My commission expires
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